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1例42岁女性患者因衣原体、支原体感染服用米诺环素,首剂0.2g,以后每12h服用0.1g。服药5d后患者出现腰痛;第6天停药1d,腰痛症状有所减轻;第7天又继续服药。第10天患者出现发热、剧烈头痛、肉眼血尿。次日出现胸闷、气短及干咳。停用米诺环素,血常规检查示:WBC10.08×109/L,N0.73;尿常规:WBC7～8个/HP,RBC(+++),Pro(+++)。入院后,CT检查示右肺上叶弥漫性浸润,两侧胸腔积液。先后给予美西林、川芎嗪和阿奇霉素静脉滴注,胸痛、胸闷症状有所减轻。诊断为肺变应性血管炎,给予地塞米松和氯苯那敏治疗,呼吸道症状进一步改善。入院10dCT检查示两肺病灶及胸腔积液完全吸收。另外,肾组织活检显示为IgA肾病。给予地塞米松、阿司匹林、双嘧达莫、贝那普利和川芎嗪治疗。1月后尿常规检查:尿蛋白(-),尿潜血(-)。
A 42-year-old female patient was given minocycline because of chlamydia and mycoplasma infection. The first dose was 0.2 g and 0.1 g after 12 h. The patient presented with low back pain after 5 days of medication. On the 6th day of withdrawal, the symptoms of lumbago were relieved. The medication was continued on the 7th day. On the 10th day, the patient developed fever, severe headache and gross hematuria. The next day chest tightness, shortness of breath and dry cough. Decommissioned minocycline, blood tests showed: WBC10.08 × 109 / L, N0.73; urine routine: WBC7 ~ 8 / HP, RBC (+++), Pro (+++). After admission, CT examination showed diffuse infiltration of the upper lobe, pleural effusion on both sides. Has given meclizin, ligustrazine and azithromycin intravenous infusion, chest pain, chest tightness symptoms have eased. Diagnosis of lung allergic vasculitis, given dexamethasone and chlorpheniramine treatment, respiratory symptoms further improved. Admission 10dCT examination showed two lung lesions and pleural effusion completely absorbed. In addition, renal biopsy showed IgA nephropathy. Dexamethasone, aspirin, dipyridamole, benazepril and tetramethylpyrazine were given. Urine routine examination after January: urinary protein (-), urinary occult blood (-).